Lane Kenworthy
January 2023

Here are some goals and strategies for how to live a healthy and happy life. Some of this comes from personal experience and opinion, but a decent amount is evidence-based. For me, these are aspirational; I don’t live up to them to the degree I’d like. And to the extent I do, it’s partly because I’ve had the good fortune to stumble into them rather than because I consciously set out to achieve them.

GET EDUCATED

Income is one of the best predictors of happiness, and education is one of the clearest routes to higher income.¹ In the United States, the boost in happiness is smaller beyond a household income of about $75,000,² so you don’t need to get a medical degree or even necessarily a four-year college degree. But schooling has lots of other benefits too, from meeting potential friends to learning self-discipline to getting a better understanding of how things work.

For those considering college, the cost is often an impediment. But the “sticker price” of college tends to be misleading; for students with limited financial resources, there is lots of financial aid along with income-based loan repayment options.³ The problem is that few people know about these.

What if you can’t get into a good and/or affordable four-year college? Consider community college. They’re widely available, they admit most students who have a high school degree, and they’re relatively inexpensive. They also allow flexibility in course scheduling. A two-year certificate or degree is helpful, and it offers opportunity to transfer to a four-year college if that’s what you want.⁴

HAVE A PURPOSE

Do things you feel competent at and enjoy.

How do you figure out what that is? It’s difficult to decide what you like and what you’re good at simply by thinking. Better to experiment. Try new things. If they don’t work or you don’t like them, try something else. And see failure as helpful, not shameful; it gives you useful information.⁵

BELONG

Spend a lot of time with friends and family. Resist the temptation to settle for small amounts of “quality time.” To the extent you’re able, commit to more hours, more days, more weeks. It doesn’t have to be only family and friends — pets, neighbors, workmates, teammates, support group members, acquaintances, or others may do just as well.⁶

If you don’t have a close connection with anyone, consider volunteering. This allows you to help others as you help yourself.

EAT WELL

About 80% of our longevity and long-term health is a product of how we live, rather than of our genes,⁷ and what we eat is one of the most consequential components of lifestyle.⁸

Eat mostly vegetables, fruits, beans, lentils, whole grains, nuts, and seeds, in unprocessed or minimally-processed form, and in moderate quantities.⁹ Drink mostly water.

There is a great deal of food science research on the health impact of individual substances (omega-3s, cholesterol, etc) and individual foods, but this has yielded limited information about what we should and shouldn’t eat, perhaps because scientists haven’t yet identified the really important substances, or more likely because there are complex interactions within and between foods that outweigh the impact of specific substances.¹⁰

Our knowledge about how best to eat comes mainly from comparative analysis of eating patterns (diets) — of people in different places, of people in the same place over time, and of people who move between places. For instance, Dan Buettner and his research team studied places where a larger-than-normal share of the population lives to age 100 or more.¹¹ It isn’t only about living longer; the centenarians in these places — in Costa Rica, Greece, Italy, Japan, and the United States — have “healthy lives with vitality until the very end.” Buettner identifies several commonalities: (1) Eat mostly plants, no ultraprocessed foods, not too much. (2) Move frequently. (3) Have a purpose. (4) Belong. (5) Relieve stress. (I say more about 2-5 above and below.)¹²

A very helpful summary of what we know and don’t know, with both a good overview and lots of detail, is How to Eat: All Your Food and Diet Questions Answered, by Mark Bittman and David Katz. A few passages¹³:

• “What do you mean by the terms ‘whole food’ and ‘real food’? It’s pretty simple: food that’s as close to ‘natural’ — that is, as nature produces it — as possible. We know that ultraprocessed (or hyperprocessed) foods are bad for us: That’s the majority of food invented in the twentieth century — junk food. Whole food is generally food that hasn’t been tinkered with much, that doesn’t need a label, and is its own ingredient.”
• “What we don’t have is a single randomized trial, beginning before birth, lasting a lifetime, enrolling tens of thousands — to show once and for all ‘what diet is best.’ What we do have is a mountain of evidence, built a bit at a time, supporting the theme of … real foods, close to natural form, mostly plants, augmented a little bit by almost whatever else you like. It’s that simple.”
• “We don’t need to create randomized controlled trials to prove in a less controversial way that fruits and vegetables are good for people…. We have no randomized controlled trials to prove the harms of smoking…. What we know about smoking is from the experience and pattern consistency of large populations, when there is a dramatic change when they smoke. It’s not from randomized trials…. Are there other, more reliable ways to learn about nutrition? Absolutely. The truly reliable way is to look at the big picture — to see the elephant — not just a piece; to look across the broadest expanse of evidence, including but not limited to intervention trials, what we know about our own native past, and what we can observe about the fate of whole populations over generations. Different kinds of evidence are like different pieces of the same, great puzzle — you need lots of different pieces to complete the picture.”
• “Should I be eating high or low in fat? What about high or low in carbs? It doesn’t matter. You don’t need to worry about it. One of the greatest distractions in modern thinking about diets is how high or low a dietary pattern is in particular macronutrients.”
• “You don’t need any particular food to have a great diet. If you have a great diet, you will derive maximum health, vitality, and longevity benefits from it, and no so-called superfood will add to that…. Overwhelmingly, the evidence links large-scale dietary pattern, not the addition of ‘superfoods,’ to health. One of the reasons we struggle so in our apparent confusion about diet is that there’s a lot of research attempting to isolate the effects of any one food. That’s nearly impossible to do.”
• “Eat a variety of wholesome foods, and the nutrients will take care of themselves…. What do these magical nutrient compounds do? We don’t know exactly. That’s the beauty of it. They make you healthy…. The notion that you can define the quality of a diet on the basis of a particular nutrient level is misguided and antiquated, and it needs to be abandoned. It’s really about the food as a whole, not food’s component parts.”

While there is very strong evidence linking a whole-food plant-based diet — heavy on vegetables, fruits, beans, lentils, whole grains, nuts, and seeds, light on animal products and ultraprocessed foods — with better health, as far as I’m aware we don’t currently know the magnitude of the effect. For instance, if a person switches at age 20 from a traditional western diet to a whole-food plant-based diet, how much will her life expectancy increase? I haven’t come across a good answer.¹⁴

On health grounds alone, the available evidence doesn’t favor a plant-only diet over a plant-predominant diet.¹⁵ The case for eating only plants is strengthened by ethical considerations, climate concerns, and growing antibiotic resistance due to large-scale animal production.¹⁶

A generation or even a decade ago, eating a diet of mostly or only minimally-processed plants in the United States likely meant a lot of blah meals. Happily, that’s no longer true. There are hundreds of tasty, healthy plant-only dishes you can make or buy.¹⁷

Here are a few short reads, podcasts, and videos on how to eat well:

• David L. Katz, Plant Proof podcast with Simon Hill, Episode 108, 2020.
• Jane E. Brody, “Secrets to Lasting Weight Loss,” New York Times, 2018.
• Gil Carvalho, Nutrition Made Simple YouTube channel.
• Movies inevitably gloss over important details, but these are pretty good: Forks Over Knives, 2011; Game Changers, 2019; Code Blue, 2020.

MOVE FREQUENTLY

It doesn’t have to be strenuous. Low-intensity activity is good enough. Walk, cycle, garden, cook, clean the house or yard, water the plants, take the stairs, hike, do tai chi or yoga, swim.¹⁸

In addition to improving health, regular movement seems to elevate mood and life satisfaction.¹⁹ And it helps us to think and understand.²⁰

TAKE TIME

We tend to underestimate the happiness benefit of leisure time. According to one recent calculation, taking 8 additional vacation days in a year yields, on average, a boost in happiness equivalent to that from $4,500 of additional income. Outsourcing your most disliked household chore boosts happiness the same amount as an additional $18,000 in income. The happiness increase from spending less time at work and more with friends and family is even greater.²¹

There also is evidence that frequent interruptions of our leisure time make us feel as though we are time deprived. Smart phones and social media are a key culprit here.²² I use my phone for calls, texts, email, and an RSS feed (no Twitter, Instagram, TikTok, Reddit, Facebook, or other social media). The phone notifies me only when I get a call or text, which isn’t that often. I feel like this works pretty well, though that might not be true for others.

MANAGE STRESS

Stress is unpleasant, and it’s bad for both physical and mental health.²³ Slow down, pause to appreciate (“smell the roses”), listen to music, laugh, smile, take a few moments or a few minutes to breathe slowly and deeply, meditate,²⁴ do some gentle stretching, eat slowly and without phones or other electronic distractions, get enough sleep, pray, give thanks,²⁵ forgive.

SLEEP

Inadequate sleep reduces energy, increases irritability, and impedes cognitive functioning. It appears to be causally linked with overweight and obesity, heart disease, stroke, type 2 diabetes, anxiety, depression, cancer, and dementia.²⁶

How much does it matter? According to one recent study of 55,000 people aged 50 to 75 in England, Finland, and Sweden, suboptimal sleep reduces healthy and chronic-disease-free life expectancy by one to six years.²⁷ That suggests sleep is quite important. On the other hand, sleep patterns don’t seem to correlate with major over-time trends or cross-country differences in health outcomes.²⁸

Adults tend to do best if they regularly get 6 to 9 hours of sleep. Many sleep experts have concluded that the lower bound is 7 hours.²⁹ However, in Japan and South Korea people appear to get fewer than 7 hours per night on average, and in those two countries life expectancy is among the world’s highest and obesity is among the lowest.³⁰ Several recent studies of several hundred thousand individuals have found that 7 hours per night is optimal, with a bit less than that just as good as a bit more.³¹ Evidence from existing “preindustrial” societies also challenges the conclusion that 7 hours is the minimal healthy amount.³²

Sleep with few or no interruptions may be just as important, possibly more important, than sleep duration.³³

Evidence-based strategies for better and longer sleep include going to bed and waking up at the same time every day, setting your sleep schedule based on your chronotype (about a third of people are early birds, a third are night owls, and a third are in between), keeping your sleep environment dark and below 70°F, minimizing caffeine and alcohol consumption in late afternoon and evening, avoiding sleep-impeding drugs (such as Adderall and Ritalin), avoiding naps after 3pm, avoiding heavy meals and vigorous exercise in late evening, minimizing screen use immediately before bed, and getting treatment for disorders such as sleep apnea and chronic insomnia.³⁴

SEEK HELP FOR MENTAL ILL-HEALTH

In the affluent nations for which good data are available — the US, UK, Australia, and Germany — mental health problems are the single largest contributor to misery (very low life satisfaction). They are more influential than physical health problems, low income, low education, unemployment, marital status, gender, or age. For many people, treatment can help.³⁵ Medication is effective for approximately 50% of people with anxiety and depression, and the success rate for cognitive behavioral therapy is even higher.³⁶

LIVE A “GOOD ENOUGH” LIFE

Dream big, shoot for the stars, aim to excel, compare yourself to others. But don’t go overboard. If you spend too much time and effort striving for something better, you may go through life with limited enjoyment. And there’s so much to enjoy. Don’t miss it because you’re obsessed with getting better or getting ahead.

DON’T DEFINE WORTH BY ACCOMPLISHMENTS

Salary, job title, employer, college — these things too often determine how we assess a person. Much more important is the type of person you are. Are you kind, empathetic, helpful to those who depend on you, and also to those who don’t?

Does this contradict my earlier point about the value of education and income? Not at all. You’re likely to be healthier and happier if you have more education, but that doesn’t mean the way you view other people should hinge on their schooling, job, or income.

BE KIND

Jesus’s version: “Do unto others as you would have them do unto you.” The (14th) Dalai Lama’s: “If you want others to be happy, practice compassion. If you want to be happy, practice compassion.”

BE HUMBLE

A person’s beliefs, values, and behaviors are determined by a complex mix of biology, experiences, contacts, and other things. This makes it very difficult to understand why a particular individual thinks what they think and acts the way they do. Similarly, despite huge advances in scientific knowledge over the past few centuries, there is an enormous amount we don’t understand. This calls for humility.

HELP OTHERS

If you’ve been lucky — in your genes, parents, teachers, friends, job, partner, or other things — give something back. A good way to do this is by volunteering or donating, but for some people the best way might be by being better at your job, or being a better neighbor, or joining a social movement, or getting involved in politics.

If you have more money than you need, consider donating. There now is good evidence that nongovernmental organizations can save lives in the world’s poorest countries, and we know approximately how much it costs to do so.³⁷

Generosity isn’t just good. It also seems to make us happier.³⁸